Cited by 1,523Acute Kidney Injury ResearchCOVID-19 Clinical Research StudiesChronic Kidney Disease and Diabetes

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Acute kidney injury in patients hospitalized with COVID-19

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Hirsch, Jamie S., Ng, Jia H., Ross, Daniel W., Sharma, Purva, Shah, Hitesh H., Barnett, Richard L., Hazzan, Azzour D., Fishbane, Steven, Jhaveri, Kenar D., Abate, Mersema, Andrade, Hugo Paz, Barnett, Richard L., Bellucci, Alessandro, Bhaskaran, Madhu C., Corona, Antonio G., Chang, Bessy Flores, Finger, Mark, Fishbane, Steven, Gitman, Michael, Halinski, Candice, Hasan, Shamir, Hazzan, Azzour D., Hirsch, Jamie S., Hong, Susana, Jhaveri, Kenar D., Khanin, Yuriy, Kuan, Aireen, Madireddy, Varun, Malieckal, Deepa, Muzib, Abdulrahman, Nair, Gayatri, Nair, Vinay V., Ng, Jia H., Parikh, Rushang, Ross, Daniel W., Sakhiya, Vipulbhai, Sachdeva, Mala, Schwarz, Richard, Shah, Hitesh H., Sharma, Purva, Singhal, Pravin C., Uppal, Nupur N., Wanchoo, Rimda, Bessy Suyin Flores Chang, Ng, Jia Hwei.·2020·Kidney International

DOI 10.1016/j.kint.2020.05.006PMC PMC7229463

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Abstract

The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and outcomes of AKI in patients hospitalized with Covid-19. We reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.

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Authors: Hirsch, J. S., Ng, J. H., Ross, D. W., Sharma, P., Shah, H. H., Barnett, R. L., Hazzan, A. D., Fishbane, S., Jhaveri, K. D., Abate, M., Andrade, H. P., Barnett, R. L., Bellucci, A., Bhaskaran, M. C., Corona, A. G., Chang, B. F., Finger, M., Fishbane, S., Gitman, M., Halinski, C., Hasan, S., Hazzan, A. D., Hirsch, J. S., Hong, S., Jhaveri, K. D., Khanin, Y., Kuan, A., Madireddy, V., Malieckal, D., Muzib, A., Nair, G., Nair, V. V., Ng, J. H., Parikh, R., Ross, D. W., Sakhiya, V., Sachdeva, M., Schwarz, R., Shah, H. H., Sharma, P., Singhal, P. C., Uppal, N. N., Wanchoo, R., Chang, B. S. F., & Ng, J. H.
Affiliations: Donald & Barbara Zucker School of Medicine at Hofstra/Northwell (US)
ORCID: Bellucci, Alessandro
Bhaskaran, Madhu C.
Corona, Antonio G.
Finger, Mark
Halinski, Candice
Hong, Susana
Malieckal, Deepa
Nair, Vinay V.
Sachdeva, Mala
Singhal, Pravin C.
Venue: Kidney International
Publisher: Elsevier BV
Published: 2020-07
Volume: 98
Issue: 1
Pages: 209-218
ISSN: 0085-2538 (ISSN-L)
DOI: 10.1016/j.kint.2020.05.006
PMC: PMC7229463
OpenAlex: W3025305522
Cited by: 1,523
References: 31
Citations by year: 2026: 37 · 2025: 65 · 2024: 120 · 2023: 203 · 2022: 341 · 2021: 462 · 2020: 288
FWCI: 204.96
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1461 d)
Locations: Kidney International (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (R01DK118017)
Topics: Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords: acute kidney injury, COVID-19 pandemic, hospitalized patients, risk factors, mechanical ventilation, respiratory failure, renal replacement therapy, AKI staging, mortality, diabetes mellitus, vasopressors, racial disparities
MeSH terms: COVID-19, Aged, Female, Humans, Inpatients, Male, Middle Aged, New York City, Pneumonia, Viral, Respiratory Insufficiency, Retrospective Studies, Coronavirus Infections, Acute Kidney Injury, Pandemics

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